More serious post...
Been trying to get my head round all the BMJ info and have tried to simplify things abit for myself, not sure if this will help others do the same. Goes without saying there may be some massively idiotic mistakes...
BMJ XMRV/CFS Scandal
A Dutch study(Van Kuppeveld et al) of XMRV in ME/CFS has been published in the BMJ and was defined as being a 'well characterized' study.
Quote from Fiona Godlee in BMJ
"The paper by Van Kuppeveld and colleagues is an unusual paper for the BMJ to publish. As our research highlights page explains, we would usually reject a small case-control study examining the prevalence of a virus in 20 year old blood samples..... We and our reviewers also thought it was well done.”
So forgetting that they used 20 year old blood samples and failed to detect XMRV in any of their samples for second...
“Well characterized” implies that the patients studied were robustly and meaningfully comparable to those in the landmark Science XMRV study(which it was attempting to replicate).
Namely:
Canadian/Fukuda Criteria Chronic Fatigue Syndrome patients with severe disability, reproducible immune abnormalities, cognitive deficits, prolonged, disabling fatigue, low V02 max, and multiple longitudinal measurements of clinical and laboratory abnormalities.
Where did the Van Kuppeveld cohort come from and how were they defined?
Van Kuppeveld’s cohort description:
"All patients and controls examined in this study were part of a Dutch cohort of 298 patients, which has been described in detail(2 citations provided below). All patients of this cohort fulfilled the Oxford criteria…."
The two papers cited as sources for the patients for the BMJ Van Kuppeveld study were
1. Vercoulen JH, Swanink CM, Fennis JF, Galama JM, van der Meer JW, BleijenbergG. Dimensional assessment of chronic fatigue syndrome. J Psychosom Res 1994;38:383-92.
2. Swanink CM, Vercoulen JH, Galama JM, Roos MT, Meyaard L, van der Ven-Jongekrijg J, et al. Lymphocyte subsets, apoptosis, and cytokines in patients with chronic fatigue syndrome. J Infect Dis 1996;173:460-3.
The cohort for the Swanink study were randomly selected from the database of patients used for The Vercoulen Journal of Psychosomatic Research Study. Therefore the entire cohort of the BMJ XMRV study came from the original Vercoulen study in the Journal of Psychosomatic Research.
Van Kuppeveld’s cohort description also reveals that the initial group consisted of 395 self-referred patients. But patients with definite or suspected illnesses causing fatigue were then excluded as were patients taking heart meds (which would include many advanced ME/CFS patients). After the exclusion process the final study sample totalled just 298 patients.
It also reveals there was no mention of post exertional malaise (the pathognomic sign for Canadian-Criteria ME/CFS ) in the patients self reported list of symptoms and only 26% reported recurrent infections. Also noteworthy is that 36% met the criteria for clinical depression.
Conclusion
The cohort for the Van Kuppeveld’s study is in stark contrast to that of the original Science study and the two are not comparable in any meaningful way. The Science study used the Canadian/Fukuda Criteria Chronic Fatigue Syndrome patients with multiple longitudinal measurements of clinical and laboratory abnormalities . The Van Kuppeveld study used the vague Oxford Criteria, excluded all patients with any sign of physical illness and also had a high number of patients with clincal depression.
Will the BMJ retract this study now these facts have come to light?
